Tailbone Injury (Coccyx Injury)

Dr. Nadheer K M (AIIMS)MBBS

February 04, 2020

June 04, 2022

Tailbone Injury
Tailbone Injury

Humans aren’t the only mammals without tails - gorillas and chimpanzees don’t have them either. Clearly, we lost our tails during evolution but we still have a tailbone: a triangular structure at the bottom part of the spine, below the sacrum.

Also known as the coccyx, the tailbone comprises four bones which provide attachment for the ligaments and muscles of the pelvic floor. Tailbone injuries can lead to either bruising or fracture in these bones. Apart from severe pain and tenderness, some tailbone injuries can restrict the range of motion of the legs.

Risk factors for tailbone injury include obesity and incorrect posture. Some women may get a tailbone injury while giving birth through vaginal delivery. In fact, women are more prone to tailbone fractures than men.

Treatment options include resting the area, ice application, and making the patient as comfortable as possible. In some cases, doctors may give steroid injections or nerve block to reduce the pain. In patients who don't respond to any of these treatment methods, surgery may be needed to partially or fully remove the tailbone.

Read more: Bone pain: symptoms, causes, diagnosis and treatment

Tailbone injury symptoms

These are the symptoms that could be seen in people with a tailbone injury:

  • Tenderness in the lower back.
  • Constant pain on top of the buttocks area.
  • Feeling of numbness while sitting.
  • Bruising at the base of the spine.
  • Swelling and inflammation around the base of the spine.
  • The person is unable to bend down.

If you start having symptoms like muscle weakness in either one or both the legs and inability to control the bladder (urinary incontinence), then you must seek medical help.

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Tailbone injury causes

Many tailbone injuries are caused due to trauma, like a sudden jerk to the spine on sitting or falling down on a slippery floor, which leads to either bruising or fracture of the tailbone. The most common causes of tailbone injury are:

  • Fall: Any direct fall onto the back can lead to injuries like subluxation (partial dislocation) of the coccyx or dislocation of the coccyx which can lead to severe pain in the tailbone region.
  • Obesity: Due to the extra weight, the spines of obese and overweight people are under continuous pressure.
  • Incorrect posture: Sitting in one position for a long time builds up pressure on your tailbone. This can lead to bruising of the tailbone region. (Read more: Exercises to improve your posture)
  • Childbirth: Towards the end of the pregnancy, the coccyx becomes flexible so it becomes easier to deliver the baby. But in some cases, because of excessive pushing, the ligaments around the coccyx get strained, causing excessive pain in the lower back. Sometimes the coccyx also gets fractured due to the pressure.
  • Repetitive strain: Sports like cycling and rowing which require the athletes to lean forward and stretch the back can lead to repetitive strain injury in the tailbone.

How to prevent tailbone injury

You can follow these measures in order to prevent tailbone injury:

  • Obese people should try to bring down their body weight to reduce pressure on the tailbone.
  • Sit in a proper posture by leaning a little bit forward. 
  • Try and walk around after every half an hour. Do not sit in the same spot for long hours.
  • Do not wear tight jeans or trousers, especially while travelling, to avoid creating pressure on the tailbone.
  • Wear shoes with good tread or slip-resistant soles, especially in snow or on ice.

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Diagnosis of a tailbone injury

The measures to diagnose an injured tailbone are: 

  • Clinical examination: Doctors will perform a proper clinical exam like palpation of the region to check for swellings or red-blue pigmentation around the lower back.
  • X-ray: Lateral X-ray could be done to pinpoint the fractured part of the bone.
  • Magnetic resonance imaging (MRI): Advanced imaging techniques like an MRI scan can be recommended by the doctor to get a correct diagnosis.

(Consult a doctor with doctor consultation app)

Tailbone injury treatment

There are a few basic things that can help manage the injury. Treatment options can vary depending on whether you have a bruised tailbone or a fractured one.

Treatment of a bruised tailbone

A bruised tailbone would need complete rest and physical therapy for healing. Here are some of the things your doctor might suggest: 

  • Ice application: Apply ice to the bruised area to reduce the swelling and inflammation.
  • Medications: Over-the-counter drugs like ibuprofen may be taken to help relieve pain and inflammation in the tailbone. (Check with your doctor before taking any medication, especially if you have a chronic lifestyle condition.) 
  • Donut pillow: A foam pillow in the shape of a doughnut helps in relieving pressure from the tailbone.
  • Physiotherapy: Physiotherapy is done once the pain has abated somewhat. Physiotherapy can help in regaining the normal range of motion. It can also help in relieving the tense muscles and ligaments around the bone. 
  • Steroid injections: In some cases, steroid injections like corticosteroids can be given to the person to reduce inflammation and pain.
  • Nerve block: Sometimes, the doctor may inject anaesthesia into the tailbone region to calm the nerves around that area, thus reducing pain.

Treatment of a broken tailbone

A broken tailbone takes at least 12 weeks of recovery time. Since there is no way to hold a fractured tailbone in place, the treatment focuses on making the injured person comfortable while the fracture heals.

  • Non-surgical treatment of a broken tailbone: The non-surgical treatment of a broken tailbone is similar to the treatment of a bruised tailbone.
  • Surgical treatment of a broken tailbone: Surgical treatment is only given to those who do not respond to non-surgical methods. Coccygectomy is a surgery in which surgeons remove all or a part of the coccyx (tailbone), to relieve the pain and help the patient regain movement.
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Tailbone injury sleeping positions

If you have tailbone pain, you will find it difficult to sleep on your back. To decrease the pain of a broken or bruised tailbone, try doing the following:

  • Sleep on a firm mattress which gives support to the back.
  • If you are sleeping on your side, keep a pillow between your knees to maintain the position of the tailbone.
  • If you are sleeping on your back, place one or two pillows under your knees to elevate your lower back.


Medicines for Tailbone Injury (Coccyx Injury)

Medicines listed below are available for Tailbone Injury (Coccyx Injury). Please note that you should not take any medicines without doctor consultation. Taking any medicine without doctor's consultation can cause serious problems.